Exam 3 6/21 Flashcards
Risk factors of addiction
Family history of addiction
SES status and environment
Burnout
Co-occuring mental health disorders
What are the characteristics of Anorexia nervosa?
What are the 2 subtypes?
- An intense fear of weight gain
- Distorted body image
- Restrict calories with significant low BMI
- considered to be a chronic illness
-Subtypes: Restricting Type (no binging/purging) and Binge-eating/purging Type.
Normal lab value for Sodium
136-145
Normal lab value for potassium
3.5-5
Normal Lab value for Phosphate
3.0-4.5
Normal lab value for Magnesium
1.3-2.1
Cluster A:
Odd or Eccentric
Paranoid personality disorder
Schizoid
Schizotypal
Cluster A: Nursing Considerations
◦High degree of mistrust – adhere to promises, appointments, and schedules
◦Being too nice may be met with suspicion – Give straightforward explanations
◦Simple language
◦Limit setting
◦Do not try to increase socialization
◦Respect need for social isolation
◦Protect against ridicule
◦Employ interventions appropriate for suspicion
◦Strange beliefs and activities may be part of their life
Cluster B
Dramatic, Emotional, or Erratic
Antisocial
Borderline
Histrionic
Narcissistic
Cluster B: Nursing Considerations
◦Limit settings, clear and consistent boundaries
◦Document behaviors objectively (i.e. provide times, dates, circumstances) of manipulative behaviors
◦Know that having desires prevented may result in aggression
◦All staff need to be consistent
◦Understand seductive behavior is a response to distress
◦Keep communication and interactions professional
◦Clients may exaggerate symptoms
◦Assess for SI, may make suicidal gestures and inadvertently result in death
◦Remain neutral, remember behaviors come from fear and abandonment
◦Avoid engaging in power struggles, becoming defensive
◦Role model empathy.
◦Provide the client exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.
Cluster C:
Anxious or Fearful traits; Insecurity and Inadequacy
Avoidant:
Dependent:
Obsessive-Compulsive:
Cluster C: Nursing Considerations
◦Nurses should use a friendly, accepting, and reassuring approach.
◦Remember that being pushed into social situations can cause severe anxiety for these clients
◦Convey an attitude of acceptance toward fears
◦Provide the patient exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.
◦Assertiveness training can assist the person to learn to express needs
◦Avoid power struggles, need for control is high
◦Be aware clients may struggle with sudden changes in routines
◦Assist clients to identify ineffective coping and to develop effective coping techniques.
Sedative-hypnotic toxicity
Slurred speech Lethargy Pinpoint pupils Decreased O2 sat Shallow respirations Hallucinations Respiratory depression Dysrhythmias Cardiac or respiratory arrest Death
Sedative-hypnotic withdrawal
Anxiety Insomnia Diaphoresis Hypertension Possible psychotic reactions Hand tremors Nausea Vomiting Hallucinations or illusions Psychomotor agitation Possible seizure activity
Paranoid personality disorder:
Characterized by the distrust and suspiciousness toward others based on unfounded beliefs that others want to harm, exploit, or deceive that the person (defense mechanism: projection) may precede a schizophrenia diagnosis.
Schizoid:
Characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism, often uncooperative. Loners. Does not want close relationships.
Schizotypal:
Characterized by odd beliefs leading to interpersonal difficulties, and eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions.
Antisocial:
Characterized by disregard for others with exploitation, lack of empathy, repeated unlawful actions, deceit, failure to accept personal responsibility; evidence of conduct disorder before age 15, sense of entitlement, manipulative, impulsive, and seductive behaviors; nonadherence to traditional morals and values; verbally charming and engaging
Borderline:
Characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment; often self-injurious and potentially suicidal; ideas of reference are common; often accompanied by impulsivity
Histrionic:
Characterized by emotional attention-seeking behavior, in which the person needs to be the center of attention; often seductive and flirtatious.
Narcissistic:
Characterized by arrogance, grandiose views of self-importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships; often sensitive to criticism
Avoidant:
Characterized by social inhibition and avoidance of all situations that requires interpersonal contact, despite wanting close relationships, due to extreme fear of rejection; have feelings of inadequacy and are anxious in social situations
Dependent:
Characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends (defense mechanism: regression)
Obsessive-Compulsive:
Characterized by indecisiveness and perfectionism with a focus on orderliness and control to the extent that the individual might not be able to accomplish a given task
STAIRS HD *Alcohol withdrawal syndrome
Sweating Tremor Anxiety Insomnia Rapid heart rate Seizures 1-2 days Hallucinations 2-3 days Disorientation
High risk withdrawal
History of seizures, blackouts, delirium tremens
Labs for alcohol abuse
LST, (AST/ALT/billirubin), amayalse, BC (platlets), k+/Mg-
CAGE (Diagnosis)
C-cut down
A- annoyed
G- guilty
E- eye opener
Alcohol Use Disorders Identification Test (AUDIT) Score (Diagnosis)
Men 4 or more
Women 3 or more
Fatal BAL
0.4
